Proteasome inhibitors potentiate leukemic cell apoptosis induced by the cyclin-dependent kinase inhibitor flavopiridol through a SAPK/JNK- and NF-kappaB-dependent process

Oncogene. 2003 Oct 16;22(46):7108-22. doi: 10.1038/sj.onc.1206863.


Interactions between proteasome and cyclin-dependent kinase inhibitors have been examined in human leukemia cells in relation to induction of apoptosis. Simultaneous exposure (24 h) of U937 myelomonocytic leukemia cells to 100 nM flavopiridol and 300 nM MG-132 resulted in a marked increase in mitochondrial injury (cytochrome c, Smac/DIABLO release, loss of deltaPsi(m)), caspase activation, and synergistic induction of cell death, accompanied by a marked decrease in clonogenic potential. Similar effects were observed with other proteasome inhibitors (e.g., Bortezomib (VELCADE trade mark bortezomib or injection), lactacystin, LLnL) and cyclin-dependent kinase inhibitors (e.g., roscovitine), as well as other leukemia cell types (e.g., HL-60, Jurkat, Raji). In U937 cells, synergistic interactions between MG-132 and flavopiridol were associated with multiple perturbations in expression/activation of signaling- and survival-related proteins, including downregulation of XIAP and Mcl-1, activation of JNK and p34(cdc2), and diminished expression of p21(CIP1). The lethal effects of MG-132/flavopiridol were not reduced in leukemic cells ectopically expressing Bcl-2, but were partially attenuated in cells ectopically expressing dominant-negative caspase-8 or CrmA. Flavopiridol/proteasome inhibitor-mediated lethality was also significantly diminished by agents and siRNA blocking JNK activation. Lastly, coadministration of MG-132 with flavopiridol resulted in diminished DNA binding of NF-kappaB. Notably, pharmacologic interruption of the NF-kappaB pathway (e.g., by BAY 11-7082, PDTC, or SN-50) or molecular dysregulation of NF-kappaB (i.e., in cells ectopically expressing an IkappaBalpha super-repressor) mimicked the actions of proteasome inhibitors in promoting flavopiridol-induced mitochondrial injury, JNK activation, and apoptosis. Together, these findings indicate that proteasome inhibitors strikingly lower the apoptotic threshold of leukemic cells exposed to pharmacologic CDK inhibitors, and suggest that interruption of the NF-kappaB cytoprotective pathway and JNK activation both play key roles in this phenomenon. They also raise the possibility that combining proteasome and CDK inhibitors could represent a novel antileukemic strategy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anisomycin / pharmacology
  • Antineoplastic Agents / pharmacology*
  • Apoptosis / drug effects*
  • Blast Crisis / pathology
  • Boronic Acids / pharmacology
  • Bortezomib
  • Cyclin-Dependent Kinases / antagonists & inhibitors
  • Cysteine Endopeptidases
  • Enzyme Inhibitors / pharmacology*
  • Flavonoids / pharmacology*
  • Gene Expression Regulation, Neoplastic / drug effects
  • HL-60 Cells
  • Humans
  • JNK Mitogen-Activated Protein Kinases
  • Jurkat Cells
  • Leukemia, Myeloid, Acute / pathology
  • Leupeptins / pharmacology*
  • Mitogen-Activated Protein Kinases / metabolism*
  • Multienzyme Complexes / antagonists & inhibitors*
  • NF-kappa B / metabolism*
  • Piperidines / pharmacology*
  • Proteasome Endopeptidase Complex
  • Pyrazines / pharmacology
  • Tumor Cells, Cultured
  • U937 Cells


  • Antineoplastic Agents
  • Boronic Acids
  • Enzyme Inhibitors
  • Flavonoids
  • Leupeptins
  • Multienzyme Complexes
  • NF-kappa B
  • Piperidines
  • Pyrazines
  • alvocidib
  • Bortezomib
  • Anisomycin
  • Cyclin-Dependent Kinases
  • JNK Mitogen-Activated Protein Kinases
  • Mitogen-Activated Protein Kinases
  • Cysteine Endopeptidases
  • Proteasome Endopeptidase Complex
  • benzyloxycarbonylleucyl-leucyl-leucine aldehyde